| NPI | 1831551902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 55927) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: KY 55927) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-08-19 |